Altered HDL composition is associated with risk for complications in type 2 diabetes mellitus in South Asian descendants: a cross-sectional, case-control study on lipoprotein subclass profiling

Background: Composition of high-density lipoproteins (HDL) is emerging as an important determinant in the development of microvascular complications in type 2 diabetes mellitus (T2DM). Dutch South Asian (DSA) individuals with T2DM display an increased risk of microvascular complications compared to Dutch white Caucasian (DwC) individuals with T2DM. In this study, we aimed to investigate whether changes in HDL composition associate with increased microvascular risk in this ethnic group and lead to new lipoprotein biomarkers. Methods: Using 1 H nuclear magnetic resonance (NMR) spectroscopy and Bruker IVDr Lipoprotein Subclass Analysis (B.I.LISA TM ) software, plasma lipoprotein changes were determined in 51 healthy individuals (30 DwC, 21 DSA) and 92 individuals with T2DM (45 DwC, 47 DSA) in a cross-sectional, case-control study. Results: Using multinomial logistic and linear regression analyses we identified specifically reduced ApoA2 and HDL-4 plasma concentrations in DSA individuals with T2DM, revealing unique HDL compositional changes, associated with higher waist circumference, waist-to-hip ratio, HbA1c, and glucose levels, that correlated with microvascular complications. Conclusion: While in both ethnic groups HDL composition differed between controls and T2DM, the lipid changes in DSA with T2DM were of more clinical relevance with higher odds of having diabetes-related pan-microvascular complications such as retinopathy and neuropathy. These typical changes in HDL could be used as ethnicity-specific T2DM biomarkers.